At the beginning of this summer, I would like to reflect on the richness of our local ecosystem and the opportunity we have, in my eyes, to collaborate with partners such as CHUV and EPFL. Together, we indeed can offer researchers a work environment rich in intellectual stimulation and multidisciplinary expertise, allowing them to produce highly competitive science and co-create extraordinary devices.
MedTech (innovative technologies likely to improve health and the quality of care) are an excellent illustration of this successful synergy that I wish to see being maintained in the coming years.
You have certainly seen them in the media as their results are spectacular: Professor Jocelyne Bloch, a neurosurgeon at CHUV/UNIL and full professor at EPFL, and Professor Grégoire Courtine, a neuroscientist at EPFL and full professor at CHUV/UNIL, have managed to make a paraplegic patient walk again. Leading the NeuroRestore laboratory (co-financed by UNIL, CHUV, and EPFL), the two scientists, in collaboration with colleagues from Grenoble, developed a sort of "digital bridge," i.e., a brain-machine interface that transforms thoughts into spinal cord stimulation patterns to bypass a spinal injury and transmit commands to paralyzed legs. Published in Nature and led by Henri Lorach, currently an Assistant Professor in the Faculty of Biology and Medicine at UNIL, this unprecedented breakthrough required more than a decade of work. It involved dissecting the underlying mechanisms during a disruption of connection between the brain and limbs due to neurological disorders (whether from an accident, stroke, or Parkinson's disease), developing specialized implants to stimulate the spinal cord, learning to extract the intention at the brain level using artificial intelligence, which is trained to decode and translate electrical activity, and understanding how to stimulate the right place at the right time with very short latency during complex commands given by the patient. The result: recovered walking, reproducing natural movement. But Jocelyne Bloch, Grégoire Courtine, Henri Lorach, and their teams do not want to stop there. First, because their result, made visible in 2023, represents a proof of concept, but does not yet guarantee its universal accessibility. If scientists want their advances to benefit as many people as possible, the transition from 1 to 1000 patients equipped with this digital bridge can be just as difficult, if not more so, than from 0 to 1. Secondly, NeuroRestore hopes to eventually regenerate nerve fibers to repair the damaged spinal cord. To achieve this, only the combination of neuromodulation and gene therapy will have a real impact.
At the Jules-Gonin Ophthalmic Hospital, the major challenge taken on by Thomas J. Wolfensberger, Chief Medical Officer and Full Professor at UNIL, and Diego Ghezzi, Head of the "Ophthalmic and Neural Technologies" group and former assistant professor in bioengineering at EPFL (Medtronic Chair of Neuroengineering), is to partially restore sight to blind and visually impaired people affected by genetic diseases that cause cell degeneration. The idea? To develop a device that attaches to the residual tissues of the retina to capture light and convert it into electricity (much like solar panels do), generating an image, even if imprecise, via the optic nerve. The first implants, dating from the 1980s, allowed for a vision recovery of 10 to 15 degrees (equivalent to focusing on one's own fingertip at arm's length). A result largely insufficient to improve the autonomy of patients. In an upcoming article, the two scientists indeed show that the key is not resolution, but the field of vision. Today, smartphones and artificial intelligence handle 80% of the needs of visually impaired people, especially reading, thanks to glasses that decipher texts in real time. What is still missing is better ambulatory vision to better orient oneself outdoors and identify objects indoors. However, the implants of Thomas J. Wolfensberger and Diego Ghezzi allow for a 45-degree field of vision, significantly improving the quality of life. The only hitch is that their device, successfully tested on mice and pigs (whose eyes are very similar to human eyes), has not yet been implemented on patients, as the necessary funding for clinical trials is lacking. Since it is a niche market with lower returns on investment (no long-term dependency on a drug), pharmaceutical companies are unfortunately reluctant to invest in this kind of medical advancement.
Another collaboration between UNIL and EPFL in the field of augmented humans is represented by the course Hommes/Machines I and II taught by Dominique Kunz Westerhoff, Associate Professor in French Literature, and Romain Bionda, Assistant Professor in French and Comparative Literature at UNIL, as part of the College of Humanities at EPFL. It also deals with implants and cyborgs, first in a lecture, then in a Master's thesis in Humanities and Social Sciences, which dissects the daily proximity between humans and technologies. According to Romain Bionda, the relationship between man and machine is not new, as Descartes and La Mettrie already made the connection through metaphor. Literature has long been fascinated by the figure of artificial, reproduced, or patched-up humanoids, from golems to clones, who regularly end up rebelling against their creator. Some, like Frankenstein's monster (1818), born from a conglomerate of cadavers animated by electricity, enjoy solid fame. Others, enslaved in Karel Čapek's play R.U.R. (introducing the term "robot" into the global vocabulary in 1921), annihilate humanity and raise the question of its potential replacement. After the creation of Superman in the early 20th century, known as the "man of steel," enhanced superheroes like Iron Man appeared and popularized questions related to the gains and losses of mechanical augmentation and hybridization with machines—in a very different way from the dystopian text Blood and Iron (1917) by Perley Poole Sheenan and Robert H. Davis, written around World War I, where war-wounded soldiers are "restored" by a scientist to serve in combat again. Cyberpunk and its foundational novel Neuromancer(William Gibson, 1984) then saw the emergence of post-apocalyptic fictions where humans struggle to find a place in polluted societies, plagued by crime and controlled by artificial intelligence, and where hybridization technologies can also serve as vectors for discrimination (e.g., with subcutaneous chip implants denying access to privileged spaces). Closer to us, the series Black Mirror (2011-present) has twice explored the theme of ocular implants filming reality and their consequences in terms of surveillance and relationship to reality, confirming the crucial role of fiction in ethical reflection and the imaginative experimentation of futuristic scenarios.
While MedTech researchers at UNIL and EPFL are currently working to repair damage caused to humans rather than improving them (thus distinguishing themselves from transhumanism), the alarm bells sounded by doctors, neurosurgeons, and neuroscience specialists are ironically the same as the fears haunting our collective imagination: there is a tangible risk of developing a two-speed society, where technological advances in health could be reserved for a privileged few, and where some less lucrative research fields might be neglected to the detriment of affected individuals. This type of mechanism goes against my convictions, as the "social floor" is part of the goals to achieve for rethinking a fairer and safer economy within planetary limits. In a world where reality now has the ability to catch up with fiction, I hope our research and training institutions can continue to support scientists who are committed to ensuring their pioneering inventions benefit everyone, without being guided by a unilateral logic of profit.
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